The Executive Checklist (EC-10) – a new rating instrument for clinicians assessing dysexecutive behavior

Abstract

Assessment of executive functions (EF) is often criticized for its lack of ecological validity. As a consequence, several self-and partner rating scales for EF have been developed, while rating scales designed for clinicians are lacking. We therefore developed the Executive Checklist (EC-10), a new rating scale for clinicians assessing dysexecutive behavior during neuropsychological assessment and examined its psychometric properties. Consecutive referrals from a memory clinic with subjective cognitive impairment (SCI; n ¼ 27), mild cognitive impairment (MCI; n ¼ 29), dementia (DEM; n ¼ 16), as well as 11 healthy controls were assessed with the EC-10 while performing common neuropsychological tests. Results showed that the EC-10 had excellent inter-rater reliability, good internal consistency and modest relations to cognitive laboratory measures. The EC-10 increased the classification rate above and beyond the influence of neuropsychological tests when comparing patients with SCI and MCI or between cognitively impaired and non-impaired patients. Conclusively, the present study demonstrates that clinical observations can be quantified using the EC-10 and that this rating provides valuable information. As executive deficits are common in many neurological and neuropsychiatric disorders, validating the EC-10 in broader patient groups should be an important avenue for future research. KEYWORDSAlzheimer's disease; ecological validity; executive function deficits; mild cognitive impairment; rating instrument APPLIED NEUROPSYCHOLOGY: ADULT https://doi.

Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions

“…For example, Biederman et al found only modest overlap between neuropsychological tests of EF and behavioral ratings, with neuropsychological tests proving more effective in identifying lower IQ, and behavioral ratings proving more effective in identifying higher levels of core ADHD symptoms (Biederman et al, 2008). Other studies on this topic have replicated Biederman and colleagues concerns about this modest association and have shown the limited ecological validity of neuropsychological tests (Burgess et al, 1998;Soto et al, 2020;Viklund et al, 2021). Further, different neuropsychological tests of EF may assess various cognitive factors underpinning EF, such as inhibition, cognitive flexibility, and working memory (Burgess et al, 1998), suggesting that any one neuropsychological test may not capture the full scope of the clinical impairment associated with EF deficits.…”

Development and Content Validity of IFERA-II for Adults

“…Considering the recent emphasis on the use of functional measures in the evaluation process (Barkley, 2014;Garcia-Barrera et al, 2014;Holst & Thorell, 2018;Isquith et al, 2013;Thorell & Catale, 2014;Toplak et al, 2013;Viklund et al, 2019) and the still limited availability of functional measurement instruments (Naglieri & Goldstein, 2014), especially in the Brazilian context (e.g. SATEPSI search, updated in April/2020, not resulting in the location of instruments), the future availability of IFERA-II may constitute an important contribution.…”

“…By developing and presenting a new functional measure, the present study aimed to contribute to the discussion on the ecological validity of EFs measures (Garcia-Barrera et al, 2014;Isquith et al, 2013;Roth et al, 2014;Viklund et al, 2019;Zimmermann et al, 2014) and to minimize the current limitations regarding the availability of these measures, which creates some obstacles for the multi-method evaluation of EFs, as suggested by several authors (Garcia-Barrera et al, 2014;Isquith et al, 2013). From this study, the final version of IFERA-II was created, and new investigations are underway to verify its psychometric properties, including information about its reliability and evidence of validity (convergence with other variables and external criteria).…”

“…In fact, an important discussion in neuropsychology refers to the ecological validity of its assessment instruments. The evaluation of EFs through performance tests have been criticized, as these tests have been considered limited in terms of their ecological validity and prediction of the behavior in the 'real world' environment (Garcia-Barrera et al, 2014;Isquith et al, 2013;Roth et al, 2014;Viklund et al, 2019;Zimmermann et al, 2014). Some authors argue that, given the complexity of the construct, a multi-method assessment should be considered, with an important role for the functional measures in measuring EFs (Garcia-Barrera et al, 2014;Isquith et al, 2013).…”

“…The Behavior Rating Inventory of Executive Function (BRIEF) was one of the first instruments developed for this purpose, and, currently, there are versions to evaluate pre-school children to adults (Roth et al, 2014). This interest was followed with the development of other scales, such as the Frontal Systems Behavior Scale (FrSBe), the Behavioral Assessment of the Dysexecutive Syndrome -Dysexecutive Questionnaire (BADS-DEX) (Garcia-Barrera et al, 2014), the Barkley Deficits in Executive Functioning Scale (BDEFS) (Barkley, 2014;Barkley & Murphy, 2010) and, more recently, the Adult Executive Functioning Inventory (ADEXI; Holst & Thorell, 2018) and The Executive Checklist (EC-10; Viklund et al, 2019), among others.…”